A double-blind, randomised, placebo-controlled study of roxithromycin and doxycycline combination, roxithromycin alone, or matching placebo for 12 weeks in adults with frequent exacerbations of chronic obstructive pulmonary disease.

Background: Azithromycin prophylaxis has been shown to reduce COPD exacerbations but there is poor evidence for other antibiotics. We compared exacerbation rates in COPD patients with a history of frequent exacerbations (at least three moderate or severe COPD exacerbations in the past two years) during a 12-week treatment course and over a subsequent 48-week follow up period.

Results: 292 patients were randomised to one of three treatments for 12 weeks: roxithromycin 300 mg daily and doxycycline 100 mg daily (n = 101); roxithromycin 300 mg daily (n = 97); or matching placebos (n = 94).

Biomarkers of cardiac dysfunction and mortality from community-acquired pneumonia in adults.

Background: Cardiac dysfunction is common in acute respiratory diseases and may influence prognosis. We hypothesised that blood levels of N-terminal B-type natriuretic peptide (NT-proBNP) and high-sensitivity Troponin T would predict mortality in adults with community-acquired pneumonia.

Methods And Findings: A prospective cohort of 474 consecutive patients admitted with community-acquired pneumonia to two New Zealand hospitals over one year.

Biochemical markers of cardiac dysfunction predict mortality in acute exacerbations of COPD.

Background: Retrospective studies suggest that plasma levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) and cardiac troponin T are often elevated in patients with acute exacerbations of chronic obstructive pulmonary disease (COPD) and are associated with increased mortality. These cardiac biomarkers were investigated in an unselected cohort of patients admitted to hospital with exacerbations of COPD.

Methods: Consecutive patients with physician-diagnosed COPD exacerbation but without clinical evidence of acute cardiac disease admitted to a public hospital over a 1 year period were studied prospectively.

Predicting early mortality in acute exacerbation of chronic obstructive pulmonary disease using the CURB65 score.

Background And Objective: Hospitalization for exacerbation of COPD is associated with a high risk of mortality. A risk-prediction model using information easily obtained on admission could help to identify high-risk individuals. The CURB65 score was developed to predict mortality risk in community acquired pneumonia.

Lung cancer susceptibility model based on age, family history and genetic variants.

Background: Epidemiological and pedigree studies suggest that lung cancer results from the combined effects of age, smoking, impaired lung function and genetic factors. In a case control association study of healthy smokers and lung cancer cases, we identified genetic markers associated with either susceptibility or protection to lung cancer.

Methodology/principal Findings: We screened 157 candidate single nucleotide polymorphisms (SNP) in a discovery cohort of 439 subjects (200 controls and 239 lung cancer cases) and identified 30 SNPs associated with either the healthy smokers (protective) or lung cancer (susceptibility) phenotype.

Murine typhus: a newly recognised problem in the Waikato region of New Zealand.

Aim: To characterise and investigate patients diagnosed with murine typhus in the Waikato District Health Board (DHB) region during 2006.

Method: We reviewed the hospital and general practitioner records of all patients presenting with clinical and serological evidence of murine typhus. All patients were interviewed by telephone using a semi-structured questionnaire to identify environmental risk factors for infection.

Severe community acquired pneumonia.

Early switch from intravenous to oral antibiotics is safe and reduces hospital stay

Meningococcal disease deaths and the frequency of antibiotic administration delays.

Objective: Meningococcal disease (MCD) remains a medical emergency and a frequent cause of death in previously healthy individuals. We aimed to determine the frequency and cause of delays in antibiotic administration in a cohort of deaths.

Methods: A retrospective chart review was undertaken on 140 hospitalised MCD deaths within New Zealand's serogroup B epidemic (1993-2004).

Effectiveness of beta lactam antibiotics compared with antibiotics active against atypical pathogens in non-severe community acquired pneumonia: meta-analysis.

Objective: To systematically compare beta lactam antibiotics with antibiotics active against atypical pathogens in the management of community acquired pneumonia.

Data Sources: Medline, Embase, Cochrane register of controlled trials, international conference proceedings, drug registration authorities, and pharmaceutical companies. Review methods Double blind randomised controlled monotherapy trials comparing beta lactam antibiotics with antibiotics active against atypical pathogens in adults with community acquired pneumonia.

The potential role of procalcitonin in the emergency department management of febrile young adults during a sustained meningococcal epidemic.

Objective: To prospectively investigate the diagnostic characteristics of procalcitonin as an aid in the diagnosis of meningococcal disease in febrile young adults presenting to the Waikato Hospital emergency department during a sustained meningococcal epidemic.

Methods: The study population were emergency department patients aged 14-40 years presenting with either a temperature > or = 38.0 degrees C without an obvious focus of infection, or symptoms consistent with meningococcal disease.

Evaluation of a PCR assay for detection of Streptococcus pneumoniae in respiratory and nonrespiratory samples from adults with community-acquired pneumonia.

Streptococcus pneumoniae is the most common cause of community-acquired pneumonia, but it is undoubtedly underdiagnosed. We used a nested PCR assay (targeting the pneumolysin gene) to detect S. pneumoniae DNA in multiple sample types from 474 adults with community-acquired pneumonia and 183 control patients who did not have pneumonia.